Individual
MICHELLE LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN BSN
Contact information
Practice address
705 E 200 S, PLEASANT GROVE, UT 84062-2923
(801) 318-6251
Mailing address
705 E 200 S, PLEASANT GROVE, UT 84062-2923
(801) 318-6251
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
82899863102
UT
Other
Enumeration date
12/17/2015
Last updated
12/17/2015
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